If you’re Black, you’re almost four times more likely to test positive for COVID-19 in the St. Louis metro area, hospital experts say. You’re 2.5 times more likely to be hospitalized and 1.5 times more likely to be admitted to the intensive care unit (ICU).
“This tells a story that we’ve said before — that COVID disproportionately affects the Black community,” Dr. Alex Garza, incident commander of the St. Louis Metropolitan Pandemic Task Force, said during a June 15 press briefing. “We’ve finally been able to generate some numbers to show that discrepancy.”
These statistics from the task force are based on hospitalized patients at the region’s four largest healthcare systems: SSM Health, BJC HealthCare, Mercy and St. Luke’s Hospital. They represent 2.8 million people for an area that includes surrounding counties in Missouri and Illinois.
At the task force’s hospitals, about 25% of patients tested for COVID-19 were Black — yet they made up 50% of the positive results. African Americans only make up about 19 percent of the region’s population.
“The white population is much larger than the Black community, so you can see the discrepancy between testing positive between the two communities,” Garza said.
Among the people who tested positive, about 60% were admitted to the hospital, compared to about 40 percent of the non-black population. About 50 percent of deaths were African Americans.
The death rate among the hospital patient population clearly shows the disparities, he said. For the Black community, it is 47 per 100,000, and it’s 13 per 100,000 for the non-Black community. These death rates will differ from those on the St. Louis city and the St. Louis County public health department websites because the task force is only looking at the hospitalized population, he said.
“We need to dig in more to figure out what is contributing to all this,” he said, including looking at access to quality housing, food, and resources that contribute to overall wellbeing.
However, Garza noted that the governor recently signed a budget that cut funding to some health programs and other needed areas.
“It becomes this repeating cycle, where you are slashing budgets in the state departments because you’re decreasing revenue,” he said, “but you’re decreasing revenue because it’s a public health emergency.”
Missouri ranks 50th in the nation for the amount of state funds dedicated to public health. The national median is $33.50 per person, but Missouri spends less than a quarter of that: $6. Garza said this is the time to invest in getting the results we want.
“There’s this old saying in process engineering, which is, ‘Every system is exactly built for the results that it gets,’” he said. “If you are going to build a very cheap system that is just barely surviving, then it’s going to give you the results that you built it for — which is poor health outcomes. Again, it’s not just about the health care. It has to be about something broader than that.”
Increase in transmission
All 14 counties that make up the task force’s statistical area are seeing an increase in the spread of COVID-19, said Garza, during his Monday, July 6 press briefing.
Up until the middle of June, the region was on the best-case scenario curve, with hospitalization numbers trending down, he said. However, we took a turn upwards at about June 15 — the day that the region fully “reopened.” Then there was an even sharper turn in the wrong direction at around June 27, according to the task force’s graphs. We are now on the “slow decline” curve, Garza said.
The task force analyzed several different trends in the COVID data to determine this. First, the number of people being admitted to area hospitals continues to climb.
“We know that we won’t be at zero for quite some time, but we become concerned when we see these upticks in admissions consistently over time,” Garza said.
The task force uses a “seven-day moving average” to look at new hospital admissions because it shows the overall trend. On July 6, Garza said the average is 21, which is the highest that it’s been in a month.
The seven-day average for people currently hospitalized for COVID-19 has also increased to 156. That number was 145 on July 3, and 139 on July 1.
Garza also showed the epidemiology curves for all of the counties in the task force’s statistical area, including seven Missouri counties and seven Illinois counties. All saw upticks in COVID-19 cases in June.
“Again, it’s concerning that we have an increase in transmission,” he said. “We’re seeing an increase in cases, an increase in hospitalizations. So, we need to do everything we can to interrupt that transmission.”
Wearing masks, not gathering in large groups, washing hands, and practicing social distancing are all simple ways people can help slow the spread of the virus, he said.
As of July 3, masks are required in St. Louis County and city when people are indoors (aside from one’s home) and outside if social distancing is not possible. The requirement applies to everyone over the age of 9 years old.
Garza also spoke about the reproductive number or the rate of transmission. If this number is above one, then a person with COVID-19 is on average transmitting it to another person. “If it’s below one, then they’re not,” he said. “Our best guess is, across our area, the reproductive number is above one.”
St. Louis city and St. Louis County were both at about 1.5, and St. Charles was at about 1.25, according to the graphs Garza shared. For reference, St. Louis city was at 0.9 in May, which was a huge improvement where it was in March — which was 5.0. When the region first started lifting the stay-at-home orders, leaders predicted that this number could rise.
On Monday, July 6, the task force reached a new milestone of discharging a total of 3,002 COVID-19 patients to date.
“That’s a testament to all of those healthcare workers who have been working so hard to treat the COVID patients and get them back home to their loved ones,” Garza said. “Thank you, everyone, for that.”
